One-year results of intravitreal ranibizumab 0.5 versus 2.0 mg for the treatment of exudative age-related macular degeneration

Monthly injections of 0.5-mg ranibizumab stabilize and improve vision in most patients with exudative age-related macular degeneration (AMD). The HARBOR trial compared the efficacy of high-dose ranibizumab (2.0 mg) compared to standard dose (0.5 mg) when administered monthly or as-needed (PRN). Visual acuity (VA) with the 2.0-mg dose improved significantly in patients treated monthly (+9.2 letters) and PRN (+8.6 letters) but was not superior to that achieved by patients receiving the 0.5-mg dose (+10.1 and +8.2 letters). Patients receiving the 2.0-mg dose required fewer PRN injections (6.9 vs 7.7). Parallel trials (LAST and SAVE) showed that the 2.0-mg dose often improves macular edema and VA in eyes that respond incompletely to 0.5-mg ranibizumab or bevacizumab. Unfortunately, because the primary end point in HARBOR was not met, Genentech has decided not to develop the 2.0-mg dose further.